How do people conceptualize self‐harm recovery and what helps in adolescence, young and middle adulthood? A qualitative meta‐synthesis

Abstract

ObjectiveSelf‐harm can be understood as any behavior individuals use to harm themselves, irrespective of motive. Evidence has extensively examined the epidemiology and function of self‐harm to the individual, but less is known about the subjective processes underpinning recovery. Such insights could inform therapeutic interventions to better support individuals. The present aim was to synthesize qualitative themes from eligible literature to identify how adolescents, young adults, and those in middle adulthood conceptualize self‐harm recovery and the factors impacting this process.MethodsEleven studies were identified from a systematic search of five electronic research databases: PsycINFO, Embase, Medline, Global Health, and CINAHL. Studies were critically appraised using an adapted Critical Appraisal Skills Program tool for qualitative research. A meta‐synthesis was conducted using reflexive thematic analysis to generate themes across the included studies.ResultsThemes depicted recovery as a multidimensional, nonlinear, and subjective process, characterized by a “push and pull” between states of (re‐)engagement and cessation/reduction. Transition between these states was influenced by intrapersonal and interpersonal factors which were embedded in a wider milieu of the meaning of self‐harm to the individual.ConclusionContemporary ideas of symptom eradication as the only marker of complete recovery may hinder individuals in the long‐term, presenting an obstacle both to quality of life and therapeutic progress. Movement away from self‐harm recovery as a uniform or singular phenomenon could enhance person‐centered care.

When the time is right: Men's experiences of recovery in self‐harm

“…While cessation of self‐harm is considered a key factor in recovery, recovery is more than cessation and can be described as a subjective experience involving the absence of NSSI thoughts, increased self‐acceptance, psychological recovery and increased coping skills (Lewis et al., 2019). Recovery in self‐harm among young people has been described as “a multidimensional and nonlinear process characterised by a “push and pull” between (re‐)engagement and cessation/reduction” (Lewin et al., 2023, p.17). Deering and Williams (2018) employed a qualitative meta‐synthesis and explored the lived experience of what activities might facilitate personal recovery for adults who continue to experience self‐harm.…”